We therefore did a population based cohort study in Ontario, Canada, to determine whether echocardiography before elective intermediate to high risk non cardiac surgery was associated with improved survival and shorter hospital stay.MethodsWe did a retrospective cohort study in Ontario, Canada, using the following linked population based administrative healthcare databases: the Discharge Abstract Database of the Canadian Institute for Health Information (hospital admissions), the Ontario Health Insurance Plan database (physicians’ service claims), the Registered Persons Database (vital statistics), the Institute for Clinical Evaluative Sciences Physician Database (physicians’ specialties), the Ontario Drug Benefit database (prescription drugs for people aged 65 years or older), and the Canadian census. Although these databases lack physiological and laboratory measures, such as blood pressure or haemoglobin, they have been validated for many outcomes, exposures, and comorbidities.10 11 12 13 During the study period, Ontario was Canada’s most populous province, with more than 12 million residents, all of whom have universal access to physicians’ and hospitals’ services through a publicly funded healthcare programme.CohortUsing previously described methods,6 7 8 14 we identified all Ontario residents aged 40 years or older who had the following elective non cardiac surgeries between 1 April 1999 and 31 March 2008: abdominal aortic aneurysm repair, carotid endarterectomy, peripheral vascular bypass pandora rings, total hip replacement, total knee replacement, large bowel resection, partial liver resection, Whipple procedure, pneumonectomy, pulmonary lobectomy https://www.charmspandora-canada.com/, gastrectomy, oesophagectomy, nephrectomy, or cystectomy. We selected these procedures because they carry intermediate to high risk,4 are applicable to both sexes, and are previously described in the Discharge Abstract Database.15 16 Procedural information in this database is very accurate.11 13 For people who had more than one eligible procedure during the study period, we included only the first procedure.Using previously described methods,17 we used the Ontario Health Insurance Plan database to identify the principal exposure: outpatient preoperative echocardiography (transthoracic or transoesophageal) within 180 days before surgery.

This point won’t matter if the Dolphins come out and immediately shit the bed in 2017, but for now, they’re no longer a laughingstock of the NFL. Miami was a Heat town for the past decade plus. Wearing Dolphins gear seemed almost like a dress code rather than a sign of pride.